VA-LCP Clavicle Plate 2.7 and Clavicle Hook Plate 2.7 Systems
The Variable Angle (VA) LCP Clavicle Plate 2.7 System is the next generation of internal fixation for the clavicle designed to treat medial, lateral, and shaft fractures in different size clavicles for patients of small, medium, and large stature (Fig 1). The system was created in response to clinical challenges in the current treatment of fractures of the clavicle and is available in both stainless steel and titanium alloy.
Fig 1 The VA-LCP Clavicle Plate 2.7 System comprises three dedicated plate shapes for the treatment of lateral, shaft, and medial clavicular fractures.
Based on extensive analysis of 15 anatomical parameters on more than 600 clavicle CT scans, the shapes of the VA-LCP Clavicle Plate 2.7 are designed to match the bow and contour of the clavicle for low construct prominence and enhanced plate-to-bone fit compared with other systems (Fontana AD et al. 2020). By improving overall plate fit, intraoperative plate placement is less challenging and the need for hardware removal due to irritation caused by prominent plates is reduced. The VA-LCP Clavicle Plate 2.7 System comprises a selection of plates to address fractures in specific segmental regions of the clavicle (Fig 2). Lateral and shaft plates are available in three sizes corresponding to a patient's height and clavicle length.
Fig 2 The clavicle divided into fifths. The VA-LCP Clavicle Plate 2.7 System provides fracture zone specific fixation.
Additional plate options are also offered to address alternative clinical settings. The VA-LCP Clavicle Plate 2.7 System is the first system to include a dedicated medial plate designed to treat medial clavicular fractures (Fig 3). The XL shaft plate is designed for extended shaft fractures in larger patients' anatomies (Fig 4).
Fig 3 VA-LCP Clavicle Medial Plate 2.7 designed for fractures located at the medial end of the clavicle.
Fig 4 VA-LCP Clavicle XL Shaft Plate 2.7 designed for the treatment of shaft fractures in larger patients' anatomies.
All screw holes in the VA-LCP Clavicle Plates accept 2.7 mm screws which presents an important adaptation to the previous LCP 2.7/3.5 mm Clavicle Systems. The decision to utilize only one screw size enhances usability through use of a single drill diameter for all screws. Metaphyseal screws with a low-profile head have also been included in the system to provide compression when needed. Staggered screw hole positioning with pre-defined hole angulation increases screw density (compared with a plate of the same length with in-line screw holes) and is designed to achieve the required construct stability.
Fig 5 All potential insertion angulations for the VA screw in the VA-LCP Clavicle Plate 2.7 System.
VA-LCP Clavicle Hook Plate 2.7 System
The VA-LCP Clavicle Hook Plate 2.7 System provides a solution for both lateral clavicular fractures with associated acromioclavicular ligament and coracoclavicular ligament injuries and ligamentous injuries of the acromioclavicular joint. Higher grade acromioclavicular joint dislocations require surgical fixation. One option for surgical treatment is the hook plate although its use has historically been associated with pain and impingement causing some patients to request implant removal before complete healing. The VA-LCP Clavicle Hook Plate 2.7 System has enhanced hook geometry designed to reduce pin-point contact of the hook on the underside of the acromion.
The system includes three low profile plate types (Fig 6); Button, Short and Long, with better anatomical fit and lower construct prominence intended to reduce soft- tissue irritation and related pain. Each plate type is available in left and right with three hook depths (9 mm, 12 mm, and 15 mm) to fit the angulation of the subacromial space in a wide variety of patients (Fig 7). The hook depth and angulation has been enhanced on all three plate designs following analysis of more than 120 shoulder CT scans.
Fig 6 Available plates in the VA-LCP Clavicle Hook Plate 2.7 System.
Fig 7 The VA-LCP Clavicle Hook Plate 2.7 System comes with three hook depths, 9 mm, 12 mm, and 15 mm, to fit the angulation of the subacromial space in a wide variety of patients.
Fig 8 VA-LCP Clavicle Button Hook Plate 2.7 specifically designed for the treatment of acromioclavicular joint separations.
The VA-LCP Clavicle Button Hook Plate 2.7 is the smallest hook plate on the market and has been specifically designed for the treatment of acromioclavicular joint separations. The shortened and rounded plate body allows the hook to be targeted at the optimal contact location under the acromion with minimal incision size (Fig 8). The 2.7 mm single screw (as seen in the VA-LCP Clavicle Plate 2.7 System) reduces system complexity and facilitates ease of surgical procedure.
The dedicated plate shapes not only possess an enhanced fit but also are designed to accommodate the bow and curvature of the clavicle at corresponding fracture locations. To achieve an optimal fit, a database of more than 600 CT clavicle scans was used to influence the design of the plate shapes while taking clavicle size as well as gender and ethnicity into consideration. For outlying anatomical variation, plates are designed to facilitate 3D bending.
The VA-LCP Clavicle Hook Plate 2.7 System has undergone several mechanical tests throughout development to assess plate construct and the performance of isolated design features, such suture holes. The construct pull-out strength is non-inferior in comparison with the DPS 3.5 mm LCP Clavicle Hook Plate System. Load testing was also completed to evaluate the performance of the system during plate contouring and hook bending.
1. Fontana AD, Hoyen HA, Blauth M, et al. The variance of clavicle surface morphology is predictable: an analysis of dependent and independent metadata variables. JSES Int. 2020 Jun 19;4(3):413–421.
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